In what may prove to be a futile attempt to steer the conversation back to the original topic while relating it to the recent literary scuffle between Dust and Medic2005, I personally feel there are several issues holding USA EMS back, but the one I will further discuss is one that I could easily just point to Medic2005 and say, "Pretty much that". Instead, I'll sum it up as a lack of motivation to advance oneself in this career and the insecure, self-righteous ramblings often associated with it.
After reading Medic2005's posts in this topic, I'd say it's fairly safe to assume he is not a Paramedic and perhaps not an Intermediate. Suffice to say, it looks as if Medic is completely content in remaining in a BLS unit for the rest of his career. His regression to the childish "ALS = Always Losing Seconds, BLS = Better Life Savers" bit is a perfect example of this, but seeing the number of other people who also made this observation, I'll get off it before I get accused of beating a dead horse.
But therein lies my point and it's a major pet peeve of mine. If we were to look at a bar chart comparing the number of Basics to Intermediates and Paramedics, the bar for Basics would dwarf the other two, even if one stood on the other's shoulders and tried to extend it's arms out. The Basic bar would still stand there so proud of itself and spouting off lines like, "Paramedics save lives, EMT's save Paramedics" while the other two bars sit off to the side reading their books and studying new protocols like a square. It's when I hear this glorification of mediocrity that my blood starts to boil. Yes, I'm proud of being a Basic, but I in no way consider myself better than any Paramedic, Intermediate, or even other Basics. I only lose respect for them if they prove to me that they have no intention of progressing. For all the guys at my work, they got their Basics for the yearly bonus. They'll never advance, just stay at the bottom of the barrel.
I only intend to be a Basic for as long as I need to before I get my Intermediate (this winter), and then I'll only be an Intermediate for as long as I need to before I know I'll make a competant and informed Paramedic.
Even then, the education never stops, or at least I don't believe it should. But unfortunately, for every one person that thinks like me, there's ten thousand that don't.
In conclusion, what I feel will greatly aid EMS in the US is if more people who took the course to be a Basic, took it with the right intentions, that being to advance all the way to the top and strive to be the best of the best. As has been said many many times on this site, "Go big or go home". If you're not in it to win it, just shut your mouth.
By the way, I'm pretty sure I'm not being entirely clear with my point, but I'm exhausted as I'm typing this, so feel free to question it or ask for clarification. Even feel free to debate it. I'll check back in the morning.
Be safe out there.